States Could Play A Bigger Role In Health Care

Whatever happens on the rocky road to health care reform, the states will have a bigger role in implementing it.

That was the word from Jim Klein, president of the American Benefits Council, who spoke during today’s Sun Life Summit.

The House-passed American Health Care Act (AHCA) is in the hands of the Senate, where it could come up for a vote or could be scrapped in favor of a Senate-crafted health care bill. Although that is up in the air right now, Klein predicted one thing will happen.

“Whether the bill stalls in the Senate, or doesn’t get through the Senate, or does go through – we will see an effort made in the regulatory arena and the legislative arena to devolve more authority to the states where health care is concerned,” he said.

Klein cited Health and Human Services Secretary Tom Price’s recent action in which he sent letters to all 50 governors, urging them to ask the federal government for flexibility in administering health care reform.

In addition, the Patient Freedom Act, introduced in the Senate earlier this year, would give states three choices in implementing a health care law, Klein said. Those choices would be:

- Remain in the Affordable Care Act (ACA), along with the law's subsidies, mandates and coverage for pre-existing conditions.

- Receive no federal help with health care.

- Opt into alternative plan that would provide a uniform tax credit linked to a health savings account to help people afford a basic health insurance plan, albeit a less-comprehensive one.

“This could very well be the path forward here if the American Health Care Act should stumble in the Senate,” Klein said.

In addition to moving more authority to the states, Klein said, any attempt to repeal and replace the ACA would result in keeping the current employer-based system of health care while expanding the individual health care marketplace.

Republicans have several strategy options in getting rid of the ACA, Klein said. One strategy is to do nothing and let the current system “implode,” he said. The second strategy is to repeal the ACA and replace it with the AHCA.

The third is to figure out what needs to be done in order to shore up the individual insurance marketplace and keep insurers from exiting the marketplace. “We need provisions to do that in an orderly way,” he said. “Things like continuing the subsidies during the transition period.”

Klein said getting repeal-and-replace passed into law is crucial to Republicans in Congress as they tackle their next big agenda item – comprehensive tax reform.

“The Republicans must move forward with this in order to move on to tax reform,” he said. “They need that kind of momentum. They want the wind at their back in terms of getting a victory.”

Susan Rupe is managing editor for InsuranceNewsNet. She formerly served as communications director for an insurance agents' association and was an award-winning newspaper reporter and editor. Contact her at [email protected].